Extracare Home Health Services Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

EXTRACARE HOME HEALTH SERVICES INC

Practice address

2100 W Big Beaver Rd
Suite 200
Troy, MI 48084-3406

Phone

(734) 925-1909

NPI assigned

Sep 22, 2009

Last updated

Sep 22, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Mohammad Y Khan, PTNPI 1538608310

Title

President

Phone

(734) 925-1909

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1720312838. Details of each certification follow.

• CCN 239148 Home health agency · Active · Details

Home health agency certification: CCN 239148

Legal name

EXTRACARE HOME HEALTH SERVICES INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Jan 18, 2011

Last certification

Nov 8, 2019

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Enrollment address

2855 Coolidge Hwy
Ste 106
Troy, MI 48084-3215

Listed as

Extracare Home Health ServicesCCN 239148 · All quality measures

Ownership

Proprietary

Certified

Jan 18, 2011

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Mohammad Khan, PHYSICAL THERAPIST

  • Physical Therapist
  • Troy, MI
  • NPI 1538608310

  5% Or Greater Direct Ownership Interest, Corporate Director, Corporate Officer, W-2 Managing Employee

  CMS ownership

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mohammad Khan, PHYSICAL THERAPIST

  • Physical Therapist
  • Troy, MI
  • NPI 1538608310
  NPD Authorized official
• Abdul Hagroo

  • Physical Therapist
  • Troy, MI
  • NPI 1083112486
  NPD (past)

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Wafa Elhassan, MD

  • Internal Medicine Physician
  • Dearborn, MI
  • NPI 1699115535

  Home health agency

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1253577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253577600000",
    "number": "1720312838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 W BIG BEAVER RD",
            "address_2": "SUITE 200",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480843406",
            "telephone_number": "734-925-1909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 W BIG BEAVER RD",
            "address_2": "SUITE 200",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480843406",
            "telephone_number": "734-925-1909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXTRACARE HOME HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-22",
        "last_updated": "2009-09-22",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "734-925-1909",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Eyeglass World
• Sarah Bounab Eyub, MD
• Ezee Home Solutions LLC
• Alexis Faber, MD

• Home Health Agency in Troy, MI
• Providers in Troy, MI by specialty
• Home Health Agency in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.